How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,175 to $19,498Professionalmedian $1,096 · 10th to 90th $832 to $1,622
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $933.25 Median $5,011.87 Typical High $17,782.79 | Facility | None | $933.25 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,047.13 | Professional | None | $851.14 | $933.25 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $11,481.54 Typical High $23,988.33 | Facility | None | $1,479.11 | $11,481.54 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,445.44 | Professional | None | $831.76 | $1,096.48 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,659.59 Typical High $2,238.72 | Professional | 50 · Both sides | $1,230.27 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $691.83 Typical High $933.25 | Professional | 62 · Two surgeons | $524.81 | $691.83 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $177.83 Typical High $239.88 | Professional | 80 · Assistant surgeon | $131.83 | $177.83 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $154.88 Typical High $208.93 | Professional | AS · PA/NP assist | $114.82 | $154.88 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,862.09 Typical High $2,754.23 | Facility | None | $1,023.29 | $1,862.09 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,467.37 Typical High $6,456.54 | Facility | None | $870.96 | $3,467.37 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $5,248.07 | Professional | None | $954.99 | $1,122.02 | $5,248.07 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $954.99 Median $3,235.94 Typical High $8,511.38 | Facility | None | $954.99 | $3,235.94 | $8,511.38 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $1,949.84 | Professional | None | $954.99 | $1,380.38 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $4,570.88 Typical High $12,022.64 | Facility | None | $1,202.26 | $4,570.88 | $12,022.64 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,778.28 | Professional | None | $812.83 | $1,023.29 | $1,778.28 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $467.74 Typical High $512.86 | Professional | 52 · Reduced service | $426.58 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $186.21 Typical High $204.17 | Professional | 53 · Discontinued | $169.82 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $707.95 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $141.25 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $660.69 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $660.69 | $724.44 |
Where Indiana sits
The same service costs 18.2 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 37th of 51
$1,096
AK $4,074TX $224
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.